"It's important to me": A qualitative analysis on shared decision-making and patient preferences in older adults with early-stage breast cancer.

Autor: Lawhon VM; Division of Hematology and Oncology, The University of Alabama at Birmingham, Birmingham, Alabama, USA., England RE; School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA., Wallace AS; Orlando VA Medical Center, Orlando, Florida, USA., Williams CP; Division of Hematology and Oncology, The University of Alabama at Birmingham, Birmingham, Alabama, USA., Williams BR; Division of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA., Niranjan SJ; School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama, USA., Ingram SA; Division of Hematology and Oncology, The University of Alabama at Birmingham, Birmingham, Alabama, USA., Rocque GB; Division of Hematology and Oncology, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Jazyk: angličtina
Zdroj: Psycho-oncology [Psychooncology] 2021 Feb; Vol. 30 (2), pp. 167-175. Date of Electronic Publication: 2020 Sep 22.
DOI: 10.1002/pon.5545
Abstrakt: Objective: Shared decision-making (SDM) occurs when physicians and patients jointly select treatment that aligns with patient care goals. Incorporating patient preferences into the decision-making process is integral to successful decision-making. This study explores factors influencing treatment selection in older patients with early-stage breast cancer (EBC).
Methods: This qualitative study included women age ≥65 years with EBC. To understand role preferences, patients completed the Control Preferences Scale. Semi-structured interviews were conducted to explore patients' treatment selection rationale. Interview transcripts were analyzed using a constant comparative method identifying major themes related to treatment selection.
Results: Of 33 patients, the majority (48%) desired shared responsibility in treatment decision-making. Interviews revealed that EBC treatment incorporated three domains: Intrinsic and extrinsic influences, clinical characteristics, and patient values. Patients considered 19 treatment selection themes, the most prioritized including physician trust and physical side effects.
Conclusions: Because preferences and approach to treatment selection varied widely in this sample of older, EBC patients, more research is needed to determine best practices for preference incorporation to optimize SDM at the time of treatment decisions.
(© 2020 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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